Total Endovascular Repair of Ascending Aortic Pathology: The ENDOASC Multicentre Global Study

This international retrospective study evaluated ascending thoracic endovascular aortic repair (TEVAR) for zone 0 ascending aortic pathology in patients generally unsuitable for open repair. Between 2011 and 2024, 58 patients from 17 centers were treated for type A dissection (n=18), non-dissection native pathology (n=18), or post-surgical pseudoaneurysm or dehiscence (n=22); 21 procedures (36 percent) were urgent. Technical success was 83 percent, 30-day mortality was 10 percent, the early reintervention rate was 12 percent, and embolic cerebrovascular events occurred in 9 percent. At a median follow-up of 10.8 months, 12-month survival was 69 percent and reintervention-free survival was 78 percent. Based on these data, the authors conclude that while ascending TEVAR may be feasible in selected high-risk patients, dedicated devices are needed to improve outcomes.